The Challenge Every Asc Anesthesiologist Knows Too Well

Picture this: You’re the only anesthesiologist in your ASC. There’s no team of residents down the hall. No ENT surgeon two floors up who can create a surgical airway in an emergency. No backup.

You’re on an island.

“At an academic center, you have not just all the tools, but all the resources,” explains Dr. Adam Thaler, Medical Director at Summit Health and a board-certified anesthesiologist who trained at the University of Pennsylvania. “You have CRNAs, residents, other attendings. You just hit a button and everyone comes running.”

“Now I’m at a surgery center. I’m by myself. I have to look at it as I’m the last line of defense.”

For Dr. Thaler, who specializes in urology procedures at his ASC — everything from kidney stones to prostate tumors — airway management isn’t just a clinical concern. It’s the foundational element that makes every procedure possible.

The Wake-up Call: A Costly Complication¹

Early in his career at a teaching hospital, Dr. Thaler witnessed an event that would shape his approach to airway management forever.

A routine intubation using direct laryngoscopy failed. Then failed again. A difficult intubation ended up a surgical airway. It resulted in a complicated ICU stay, but the patient survived. ICU stays for difficult intubations are known to be significantly more costly, and this one was.¹

That experience crystallized a question that would guide his leadership at Summit Health: If video laryngoscopy could prevent even one complication like this, why wouldn’t you use it for every intubation?

The Technology Investment That Changed Everything

At his first job out of residency, Dr. Thaler discovered his hospital had a McGRATH MAC™ video laryngoscope — locked in a medication cabinet with a fingerprint scanner, as if it were a controlled substance.

“I didn’t even know what it looked like for the first few years,” he admits. The device only came out for the most challenging airways. Until one day, responding to a difficult intubation in the ICU, Dr. Thaler ran to grab the hospital’s video laryngoscope and successfully intubated the patient.

From that moment forward, Dr. Thaler carried the McGRATH™ MAC video laryngoscope whenever he was on call. His anxiety about difficult airways disappeared. He was confident in first-pass success.²

The Non-Negotiable: Video Laryngoscopy in Every OR

When Dr. Thaler took the Medical Director role at Summit Health’s ASC, video laryngoscopy wasn’t a request. It was a requirement.

“I made sure that we would have a McGRATH™ MAC video laryngoscope in every OR,” he explains. Summit Health has three operating rooms, and all three are equipped with McGRATH™ MAC video laryngoscopes. “I use them for every intubation. Every one.”

The decision wasn’t made lightly. Dr. Thaler conducted his own research, comparing the McGRATH™ MAC video laryngoscope to both the GlideScope™ video laryngoscope and traditional direct laryngoscopy. What he found was compelling:

The ROI He Experienced

• 55% lower overall cost³ compared to GlideScope™ video laryngoscope
• Lower costs than disposable direct laryngoscopy blades² when factoring in the entire cost structure
• Significant indirect cost savings from reduced complications¹ and faster first-pass success rates²

“The disposable blades cost more than the McGRATH™ MAC video laryngoscope,”² Dr. Thaler notes. “And that’s before you consider the indirect cost savings from complications and failed intubations.”¹

The Clinical Case for McGrath™ Mac Video Laryngoscope

Research shows that video laryngoscopy significantly improves first-pass intubation success² rates — even for practitioners with less experience.⁴ In the ASC setting, where you don’t have the luxury of multiple attempts or a backup team, that first-pass success rate² is critical.

To Dr. Thaler, the operational benefits became clear quickly:

• Faster intubations with higher first-pass success rates²
• Smoother procedures allowing surgeons to begin sooner⁵
• Increased staff confidence knowing they have the best tools available²

The VIP Test: A Powerful Framework for Technology Decisions

During his time at a teaching hospital, Dr. Thaler noticed something interesting. When VIP patients came through — famous individuals, politicians’ family members — the team would use video laryngoscopy.

He asked why. “They said, ‘Oh well, the odds are a little bit better of success. We don’t want to damage their tooth or give them a sore throat.’”²

Dr. Thaler’s response was simple but powerful: “If you’re going to do that for somebody that’s a VIP, why wouldn’t you treat everyone that way?”

This became his framework for evaluating any technology: Would I use this for a VIP? If yes, then every patient deserves that same standard of care.

“I want to treat all my patients the way that I would want to be treated, the way that a VIP is treated,” he emphasizes. “I give all my patients the same care as if they were a family member.”

The Results: Three Years Later

Today, Summit Health’s ASC uses the McGRATH™ MAC video laryngoscope for every intubation. The disposable direct laryngoscopy blades they purchased before Dr. Thaler joined? They’re still there, unused.

The outcomes he’s seen at his ASC speak for themselves:

• Consistent first-pass intubation success²
• No airway-related complications⁶
• Improved operational efficiency³
• High staff satisfaction and confidence²
• Cost savings that exceeded projections³

But perhaps most importantly: Dr. Thaler no longer carries that underlying anxiety about airways that many anesthesiologists know all too well.

“I never have that fear. I never have that stress anymore, because I know that I can use this right away and be successful.”

The Bigger Picture

Dr. Thaler’s focus on airway management comes at a critical time. Data shows that more than 50% of all procedures are now performed outside of hospitals, projected to reach 60–65% within the next 5 to 10 years.

As procedures migrate from hospitals to ASCs, the equipment and protocols need to evolve with them. What was once reserved for “difficult airways” in a hospital setting needs to become standard practice in environments where backup resources aren’t readily available.

For Dr. Thaler, that means approaching every decision through the lens of patient safety, clinical excellence, and operational efficiency — and applying the same standard of care to every patient that walks through the door.

Learn More

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This content was developed in partnership with Medtronic. The ASC Insights podcast series features real conversations with ASC leaders about the challenges, innovations, and strategies driving success in ambulatory surgery centers.